Kwashiorkor: What Is the Name of the Protein Deficiency Disease in Africa?

January 7, 2026 •

4 min read

According to the World Health Organization, nearly half of all deaths among children under five years of age are linked to undernutrition, with kwashiorkor being a significant factor in low- and middle-income countries. This severe form of malnutrition is particularly common in regions with high rates of poverty and food insecurity, causing debilitating symptoms in those affected.

Quick Summary

Kwashiorkor is the name of a severe protein deficiency disease common in parts of Africa, causing symptoms like edema (swelling), a distended belly, and skin and hair changes. It primarily affects children and is often linked to a diet high in carbohydrates but lacking in protein.

Key Points

Name of the Disease: Kwashiorkor is the protein deficiency disease commonly associated with Africa, especially in regions facing food insecurity.
Defining Symptom: The most notable sign of kwashiorkor is edema, or fluid retention, which causes swelling in the belly, feet, and ankles.
Cause: It primarily results from a diet that is high in carbohydrates but severely lacking in protein, often after a child is weaned from breastfeeding.
Distinction from Marasmus: Unlike marasmus, which involves overall caloric deficiency and causes extreme wasting, kwashiorkor is defined by the presence of edema.
Risk Factors: High-risk populations include young children in poverty-stricken areas with limited food access, poor sanitation, and a high prevalence of infectious diseases.
Treatment Approach: Treatment is a multi-stage process that begins with stabilizing the patient's condition, followed by careful nutritional rehabilitation to avoid complications.
Prevention: Prevention strategies focus on improving access to nutritious food, promoting proper infant feeding practices, and providing education on nutrition.

What is Kwashiorkor?

Kwashiorkor is a severe form of protein-energy malnutrition (PEM) that is widespread in developing regions, including many parts of Africa, where diets are predominantly high in carbohydrates but critically low in protein. The name "kwashiorkor" comes from the Ga language of coastal Ghana and means "the sickness the baby gets when the new baby comes," reflecting how it often affects older children who are abruptly weaned from protein-rich breast milk. A key diagnostic feature is edema, or fluid retention, which can cause a visibly swollen belly, hands, and feet. This swelling can sometimes mask the underlying severe malnutrition, making it appear that the child is not as emaciated as they truly are.

Causes and Risk Factors

While the primary cause is a diet lacking sufficient protein, the etiology of kwashiorkor is complex and influenced by several interconnected factors. These factors contribute to the high prevalence in areas with limited resources:

Dietary Imbalance: Staple foods in many high-risk areas, such as maize, rice, and cassava, are cheap and abundant but very low in protein. This leads to a diet high in energy but low in essential amino acids.
Weaning Practices: The introduction of inadequate complementary foods after breastfeeding is a major trigger. Instead of being transitioned to a protein-rich diet, toddlers are often given starchy porridges that do not meet their nutritional needs.
Socioeconomic Conditions: Poverty and food insecurity are significant risk factors. Drought, political instability, and disruptions to food supply chains exacerbate these issues, making nutritious food even more scarce.
Infections and Diseases: Frequent infectious diseases, like measles and malaria, put a heavy metabolic toll on the body and can precipitate malnutrition. Chronic diarrhea, in particular, can worsen the condition by preventing nutrient absorption.
Poor Sanitation: Unhygienic living conditions and a lack of clean water increase the risk of infections that contribute to malnutrition.

Symptoms of Kwashiorkor

In addition to the characteristic edema, kwashiorkor presents with a range of other symptoms that indicate severe nutritional deprivation:

Edema: The most defining symptom, visible as swelling in the ankles, feet, face, and a distended abdomen.
Skin and Hair Changes: The skin can become dry, peeling, and develop scaly or patchy lesions, often described as "flaky paint" dermatosis. Hair may become sparse, brittle, and change color, often developing a reddish or gray hue.
Growth Failure: Children with kwashiorkor often experience stunted growth and fail to gain weight.
Fatigue and Irritability: Affected individuals, especially children, may exhibit extreme lethargy, apathy, and irritability.
Enlarged Liver: A fatty liver is a consistent feature of kwashiorkor, which is caused by the impaired synthesis and transport of lipids.
Weakened Immune System: A compromised immune system makes individuals more susceptible to severe infections.

Kwashiorkor vs. Marasmus: A Comparison

Kwashiorkor and marasmus are both classified under Protein-Energy Malnutrition (PEM), but they have distinct differences in their presentation and underlying pathology. A mixed condition, marasmic-kwashiorkor, also exists, combining features of both.


Feature	Kwashiorkor	Marasmus
Primary Deficiency	Severe protein deficiency with adequate caloric intake, often from carbohydrates.	Severe deficiency of all macronutrients (protein, carbs, fats) and calories.
Appearance	Bloated or swollen appearance due to edema, a distended belly. Muscle wasting may be less obvious.	Visibly wasted and emaciated appearance, with severe loss of muscle and subcutaneous fat.
Characteristic Sign	Bilateral pitting edema (swelling).	Severe wasting (visible ribs and bone structure), no edema.
Skin & Hair	Skin lesions, peeling, changes in hair color and texture.	Dry, wrinkled skin that hangs loose in folds. Hair may thin but less discoloration.
Fatty Liver	Presence of a fatty liver is a common feature.	Fatty liver is less consistently observed.
Onset Age	Most common in children 6 months to 3 years, particularly after weaning.	Most common in infants and very young children.

Diagnosis and Treatment

Diagnosis of kwashiorkor typically involves a physical examination to identify characteristic signs, like edema. Anthropometric measurements, such as weight-for-height and mid-upper arm circumference, are used to assess the severity of malnutrition. Blood and urine tests help check for low protein levels (hypoalbuminemia) and other nutritional deficiencies.

Treatment follows a multi-stage approach, often based on guidelines from the World Health Organization. This process is managed carefully to avoid refeeding syndrome, a potentially fatal complication:

Stabilization: The immediate priority is to treat life-threatening conditions, including dehydration, hypothermia, electrolyte imbalances, and infection. A specialized rehydration solution (ReSoMal) and antibiotics are often administered.
Nutritional Rehabilitation: Once stable, feeding begins slowly with formulas that provide a balanced mix of calories and protein. For children, catch-up growth is encouraged with increased calorie intake over several weeks.
Ongoing Support: Before discharge, education on nutrition, proper feeding practices, and hygiene is provided to prevent recurrence. This stage is crucial for ensuring sustained recovery. For further information, visit the World Health Organization's website on nutrition.

Conclusion

Kwashiorkor is a devastating form of severe protein-energy malnutrition, tragically common in parts of Africa and other low-resource regions. Distinct from marasmus due to the presence of edema, its symptoms include a swollen belly, skin lesions, and growth failure. While early intervention and cautious refeeding are crucial for recovery, prevention remains the most effective strategy. This involves addressing underlying causes like poverty, food insecurity, lack of sanitation, and inadequate nutritional education to ensure that children and vulnerable populations have access to the balanced, protein-rich diets they need to thrive.

Frequently Asked Questions

The protein deficiency disease specifically known to be common in parts of Africa is Kwashiorkor, which is a form of severe protein-energy malnutrition.

The name Kwashiorkor comes from the Ga language of coastal Ghana and translates to "the sickness the baby gets when the new baby comes." It refers to the illness that develops in an older child who is weaned from protein-rich breast milk when a new sibling is born.

The most visible signs of Kwashiorkor are bilateral pitting edema (swelling) in the ankles, feet, and face, as well as a large, distended belly caused by fluid retention and an enlarged, fatty liver.

No, while both are forms of severe protein-energy malnutrition, they are distinct. Kwashiorkor is a protein deficiency with adequate calories and is characterized by edema, while Marasmus is a deficiency of all macronutrients and calories, resulting in severe wasting without edema.

The edema in Kwashiorkor is caused by a severe deficiency of protein, which leads to low levels of serum albumin (hypoalbuminemia). This results in an imbalance of osmotic pressure in the blood vessels, causing fluid to leak into the surrounding tissues.

Treatment for Kwashiorkor follows a cautious, multi-stage process. It starts with stabilizing the patient's condition by treating dehydration and infection, followed by slow, controlled nutritional rehabilitation using special therapeutic formulas to introduce calories and protein.

Primary risk factors include poverty, food scarcity, inadequate weaning practices, reliance on low-protein staple foods like cassava or maize, and a high prevalence of infectious diseases.